Ageing is associated with damaging ‘free radicals’ and decreased cell defences.  This ‘oxidative stress’ is implicated in dementia.  It contributes to brain degeneration and alters enzyme activity

Two enzymes metabolise homocysteine – methionine synthase (MS) and cystathionine beta-synthase (CBS).  They respond differently to oxidative stress.  MS activity decreases but CBS activity increases.  This ‘biological response’ diverts homocysteine toward glutathione synthesis.  Glutathione is a powerful antioxidant

However, neurovascular tissue cannot fully convert homocysteine to glutathione and is vulnerable to oxidative damage.  Vitamin B12 and folate, the cofactors for MS activity, are also easily oxidised

COBALZ solved this problem by raising levels of the antioxidant glutathione.  Although glutathione is not absorbed from the gut, its levels can be increased by giving N-acetylcysteine (NAC).  When given together with vitamin B12 and folate NAC improves symptoms in patients with raised homocysteine and dementia